Benefits Of Pregnancy Examination

When you and your partner are considering having a baby, you and your partner should go to see an obstetrician and gynaecologist to discuss the preparation for pregnancy. 

Pregnancy is usually safe. However, some diseases can become serious during pregnancy. In addition, for some couples, the risk of giving birth to children with genetic diseases will also increase. 

Once a couple considers having children, women should start taking a multivitamin supplement containing folic acid (folic acid) once a day. The minimum recommended intake for women of childbearing age is 400 micrograms, but some experts suggest a little higher, such as 600 or 800 micrograms. This dose is usually used for over-the-counter products, such as multivitamins. 

Folic acid reduces the risk of birth defects (neural tube defects) in the spinal cord or brain at birth. Women who have given birth to infants with neural tube defects should begin to take a much larger dose than the recommended dose: once they start to consider giving birth to more children, they should take 4,000 micrograms immediately. Only after the prescription, can they provide 1,000 micrograms or higher dose. 

If you decide to try to have a baby, your partner and your doctor will discuss how to get pregnant as healthily as possible. Ask your doctor about factors that may harm your health or the health of your developing fetus. 

Factors or situations to avoid may also include: 

• Use tobacco or alcohol 
• Exposure to second-hand smoke may be harmful to the fetus 
• Contact with cat dung (unless the cat is strictly kept at home and does not contact with other cats) will spread toxoplasmosis, which is a protozoan infection that will damage the brain of the fetus. 
• Exposed to high temperature for a long time 
• Contact with chemicals or paint dust 
• People exposed to rubella (German measles) or other infections may cause birth defects 
• Contact with people with chickenpox or herpes zoster, unless you have tested that you have chickenpox and are immune to it. chickenpox and herpes zoster are caused by herpes virus. During childbirth, these viruses can infect the fetus and cause serious diseases. The virus can also cause pneumonia in women, sometimes severe. 

Knowing how to deal with these factors before pregnancy can help reduce the risk of problems during pregnancy. 

In addition, you can discuss your diet and your social, emotional and medical problems with your doctor. 

PREGNANCY FINDINGS IN THE FIRST THREE MONTHS OF PREGNANCY. 

After pregnancy is confirmed, a physical examination should be carried out, preferably 6 to 8 weeks pregnant. It is now possible to estimate the length of pregnancy and predict the expected delivery date most accurately. 

Your doctor will ask you about your past and present problems, the drugs you take and the details of your previous pregnancy, including diabetes, miscarriage and birth defects. Your doctor will also ask about your work environment and your psychological life during pregnancy: stress, anxiety, and nature of work. 

• The first physical examination during pregnancy is very thorough, including the following: 
• Measure weight, height and blood pressure 
• Check the ankle for swelling. 
• Gynecological examination: During this examination, the doctor should pay attention to the size and position of the uterus and determine the birth defects (if any) of the uterus, cervix and colposcopy (such as double uterus, cervix wall and vagina), 
• Blood test: including analysis of complete blood cell count 
• Detection of infectious diseases (Such as syphilis, hepatitis and human immunodeficiency virus [HIV]), and detection of evidence of immunity to rubella and chickenpox. Determine the blood type, including Rh factor status (positive or negative). 
• Urine analysis test found abnormalities, such as hidden urine infection. 
• This test evaluates the health of the body: blood coagulation function, liver and kidney function, if you have never checked your health. 
• Other tests can be carried out, for example: thyroid hormone levels can be measured in some women (such as women with thyroid disease, diabetes, infertility or abortion). 
• Abnormal pregnancy gene screening: Down syndrome test, Edward, Pato.

If you are Rh negative blood, you will receive Rh factor antibody test. The immune system of Rh-negative patients produces antibodies when Rh-negative blood comes into contact with Rh-positive blood – for example, in contact with Rh-positive fetuses during the previous pregnancy. Antibodies (known as Rh antibodies) can destroy the blood cells in the fetus with Rh positive blood, causing serious problems (even death) to the fetus. If the antibodies in the blood of pregnant women are detected early, doctors can take measures to protect the fetus. All Rh-negative blood group women will receive intramuscular Rh (D) immunoglobulin in 28 weeks of pregnancy. They will also be injected after any contact between their blood and fetal blood, for example, after vaginal bleeding or amniocentesis and after birth. Rh (D) immunoglobulin can reduce the risk of fetal blood cell destruction. 

HOW TO ARRANGE PREGNANCY? 

After the first visit, pregnant women should seek medical treatment in the following ways: 

• Every 4 weeks until 28 weeks of pregnancy. 
• Then every 2 to 36 weeks. 
• Then once a week until delivery. 

At each examination, the weight and blood pressure of the pregnant woman are usually recorded, and the size of the uterus is recorded to determine whether the fetus is developing normally. Check your ankle for dents to determine your earliest edema, which usually occurs more than 20 weeks. 

The doctor checks the fetal heart rate, which can usually be detected by handheld device (fetal heart Doppler) around 10 to 11 weeks. Once the heart rate is detected, the doctor will check the heart rate at each visit to determine whether it is normal. 

Urine screening will be performed at each examination. Sugar in urine may be a sign of diabetes. If the urine contains sugar, a blood test to detect diabetes should be carried out as soon as possible. Even if the urine does not contain sugar, doctors usually check all pregnant women to detect diabetes that occurs during pregnancy. The blood test is carried out from 24 to 28 weeks. The purpose is to measure the blood glucose level (glucose) 1 hour after women drink a solution containing a certain amount of glucose, which is called glucose tolerance test. 

Risk factors for gestational diabetes include: 

• Overweight in early pregnancy or excessive weight gain during pregnancy. 
• Gestational diabetes or the large fetus in the previous pregnancy (weight more than 4500g) 
• Unexplained abortion during the last pregnancy 
• Relatives such as mother or sister with diabetes 
• A long history of sugar in urine 
• Insulin resistant polycystic ovary syndrome

If the initial test results are normal, these high-risk women will be tested again in the 24th to 28th weeks. 

At each examination, the protein content in urine is also checked. The protein in urine may be a sign of pre-eclampsia syndrome (a disease that develops into hypertension during pregnancy).

Blood tests to check for thyroid disorders are done if a woman:  

• Has symptoms of a thyroid disorder  
• Come from an area where moderate to severe iodine deficiency occurs  
• Have a family history of the disorder have had a thyroid disorder  
• Have had a thyroid disorder  
• Have type 1 diabetes  
• Have had problems with infertility, had a premature birth, or had a miscarriage  
• Have had radiation therapy to the head or neck  
• Be severely obese  
• Over 30 years old. 

 FETAL ULTRASOUND 

 Ultrasound has the following meanings:  

• Show fetal heart rate, confirms fetal viability, as early as 5 weeks gestations 
• Determine the position of the fetus in the uterus or ectopic. 
• Determine the date of pregnancy, then calculate the gestational age and predict the date of birth.  
• Determined to have one or two or more fetuses.  
• Identify abnormalities, such as a misplaced placenta (placenta previa), abnormality of the umbilical cord (sometimes vascular insufficiency), amount of amniotic fluid (oligohydramnios or polyhydramnios), or abnormal fetal position (transverse or butt).  
• Identify birth defects (sometimes).  
• Look for signs of Down syndrome (and other disorders) by measuring the fluid-filled space at the back of your baby’s neck (called nuchal translucency) 
• Indirect assessment of the health status of the fetus, which helps to determine if the pregnancy is progressing normally. 

Towards the end of pregnancy, an ultrasound can provide information to help your doctor decide if a cesarean section is needed.  

In summary, in order to prepare to welcome a new member “little angel” and prepare safely for the birth, pregnant women need to know the benefits of antenatal check-ups to perform well the examination process for themselves and baby.  

The article is translated and edited by Raul Artal-Mittelmark MD, Saint Louis University Medical School, updated May 2021, according to MSD. 

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